Flukes, Tapeworms and other Biliary Parasites: Are They Your Real Problems?

Posted by Deborah Graefer, L.Ac. MTOM
on
March 14, 2017

They say, “The best gifts come in small
packages” but I’m afraid you can’t say the same for the tiny and microscopic
parasites that may be living inside you. Just the thought of having the
wriggling, feeding, slimy creatures in your body may be enough to make your
hair stand on end. It’s bad enough that its mere mention gives us the skeevies
but the creatures themselves does so much more harm than that. These organisms
live on or in a host (can be animals or humans) and get food by hijacking their
hosts, robbing it of nutrients and leaving behind toxic waste.

Parasitic infections used to be confined to
tropical and underdeveloped countries. However, because of the ease of travel
and migration, developed countries are no longer excluded. Some of the most
popular culprits are roundworms (affecting 25% of the world population),
hookworms, flatworms, tapeworms, and pin worms among others. These parasites
may populate in various body organs, endangering the different body systems. Since
parasites are often acquired by ingesting contaminated food and water, the
gastrointestinal system, the hepatic system and biliary system are the most
common proliferation sites. There has been much written on intestinal parasites,
but much less on the biliary organs (the liver, gallbladder and bile ducts)
which will be the focus of this article.

What
are the parasites that affect the biliary system?

There are more than 100 types of parasites
that can reside in human hosts. Among these, only two types called nematodes
and trematodes can directly affect the gallbladder as well as the liver and the
gastrointestinal tract at the same time.
Clonorchis
sinensis, Opisthorchis viverrini, Opisthorchis felineus
, Fasciola hepatica and Fasciola gigantica (C.
sinensis, O. viverrini, O. felineus , F. hepatica and F. gigantica) are
leaf-like, flat flukes that like to inhabit the bile ducts and the gallbladder.
The human ascarides,
Ascaris lumbricoides,
actually dwells in the intestines but can also migrate into the gallbladder through
the bile ducts and cause bile duct obstruction.

These
trematodes measure only 10-25 mm long and 3-5mm wide. They may be small but
they have the potential to do much damage to their human host. They are commonly
known as liver flukes.

These
parasites feed on the bile or the blood of the host.

There are
about 13.5 million infected people worldwide. Not all cases are diagnosed
because these flukes can be asymptomatic. Meaning, they can live up to 50 years
within your gallbladder, bile ducts or pancreatic ducts and you may never know
it.

They are often
acquired through ingesting raw, pickled, smoked or dried fish.

b.Sheep
Liver Flukes -
Fascioliasis(F. hepatica and F.gigantica)

Commonly
known as sheep liver flukes as these are parasites often affecting herbivorous
animals. Although cases in humans are rare, they can still be acquired through
contaminated freshwater plants or when they are eaten by snails or fish that
are in turn, eaten by humans.

The adult F.
hepatica and F.gigantica live and lay eggs in the bile ducts. They can measure
up to 20-40mm in length. They can also invade the intestine.

c.Roundworm -Ascariasis
lumbricoides

These
nematodes transmitted through human feces are often found in the intestine but
can migrate to bile ducts and gallbladder.

They are
commonly called ascaris and they affect about 25% of the world’s population.

What
are the symptoms of a parasitic infection in the gallbladder?

Although the prevalence of parasitic
infections in humans is very high, many cases are left undiagnosed and
untreated. It is possible that the presence of liver flukes, sheep liver flukes
and ascaris may not be bothersome at all. Although these parasites are silently
and consistently feeding on bile and blood, there is a huge probability that it
would not trigger any symptoms. In fact, they can live for as long as 50 years
inside the human body and remain asymptomatic.

For the unfortunate population who
experiences the negative effects of theses flukes and roundworms, the symptoms
exhibited may be very vague and general. Common manifestations such as fever, diarrhea,
bloating, loss of appetite, vomiting and listlessness can be interpreted as a
plethora of diseases. In fact, most of these may be familiar to gallbladder
patients as some of them are common to both chronic gallbladder symptoms as
well as an acute gallbladder attack.

Other symptoms specific to these flukes and
ascaris affecting the GI tract, liver and gallbladder are abdominal discomfort,
dyspepsia, bile stasis (reduced flow of bile from the liver to other parts of
the body), reduced movement of the intestines, obstruction of the bile ducts,
inflammation of the organs involved and bacterial infections. Those suffering
from Ascariasis lumbricoides may have an enlarged liver and gallbladder. This
causes tenderness or sharp pain of the right upper quadrant of the body.

What
are the complications of having a biliary parasite?

Although the liver fluke, sheep liver fluke
and ascaris trigger very similar symptoms at the acute phase, complications
vary when they reach the chronic phase. Severe infestations may cause the
following:

Intrahepatic
and extrahepatic biliary obstruction - blockage of the bile ducts causing the
development of biliary sludge and abnormal bile circulation

Cholelithiasis
- development of gallstones

Gallbladder
perforation

Repetitive
cholangitis – bacterial infection of the bile ducts and gallbladder; treatable
with antibiotics but unless the cause of blockage (parasites) is addressed, the
infection will just recur.

Cholangiohepatitis
– inflammation of the liver and bile ducts

Worm
migration to the liver that can lead to damage to the organ or liver cirrhosis

Pancreatitis

Increased
chances of developing cholangiocarcinoma – cancer that arises from the cells
within the bile ducts; also called bile duct cancer

Hepatocellular
carcinoma (HCC) – cancer that starts in the liver

b.Sheep
Liver Flukes - Fascioliasis (F. hepatica and F.gigantica)

Obstructive
jaundice

Cholangiohepatitis
– inflammation of the liver and bile ducts

Acute
cholecystitis – inflammation of the gallbladder

Intrahepatic
stones – formation of stones within the liver

Cholelithiasis
- development of gallstones

Pancreatitis

Liver
abscesses – swelling of liver due to infection and collection of pus

c. Roundworm
–Ascaris (
Ascariasis lumbricoides )

Obstructive
jaundice

Cholangiohepatitis
– inflammation of the liver and bile ducts

Acute to
Chronic cholecystitis – inflammation of the gallbladder

Pancreatitis

Intrahepatic
stones – formation of stones within the liver

Cholelithiasis
- development of gallstones

Liver
abscesses – swelling of liver due to infection and collection of pus

Cholangiocarcinoma
– cancer that arises from the cells within the bile ducts; also called bile
duct cancer

Mortality

How
can it be diagnosed?

Many years ago, the presence of parasites
are usually just tested via stool exam. Thanks to modern medicine, there are now
many ways that Clonorchiasis, Fascioliasis and Ascariasis can be diagnosed.

a. Conventional Ova and Parasite Stool Test

This is the most basic test that comes with
many limitations. This can yield a false negative for the presence of parasites
depending on the life cycle of the organism, the particular sample at a given
time, the dormancy of parasites and other factors.

b. Functional Medicine Comprehensive Stool Test

More sensitive than the conventional test
because of the use of PCR technology to amplify the DNA of the parasite, if
there is one.

c. Ultrasonography, CT Scan and Magnetic
Resonance Imaging (MRI)

Useful for the imaging and demonstration of
the flukes, dilation of the biliary tree due to obstructions and the detection
of stones, cancers, abscesses or cysts. Characteristic sonographic and CT
features can be found for ascaris and clonorchis worms in the gallbladder and
nearby organs.

d. Endoscopic Retrograde
Cholangio-Pancreatography (ERCP)

This procedure enables the doctor to examine
andsee the pancreatic and bile ducts through an endoscope. ERCP does not only
help in the diagnosis but also for therapy and treatment. It can be used as an
alternative to surgical procedures.

e. Enzyme-linked
Immunosorbent Assay (ELISA) Test

This technique
detects whether an antibody or antigen against the parasite is present in the
sample.

What
is the treatment for flukes, tapeworms and other biliary parasites?

a. Medication
(Conservative Treatment)

Bithionol and
Triclabendazole for sheep liver flukes

Praziquantel
for liver flukes

Albendazole
or Mebendazole for ascaris

b. Natural Supplements

Liver
fluke detox formula

Intestinal parasite formula

Bowel cleaner

Bile movers

Note that both
medications and herbal formulas can be hard on the body and it is normal to
feel tired and flu-like symptoms from the die off of the organisms. Plan a
parasite detox when you have time to rest.

Parasite Detox Protocol

Principles – start with a liver/gallbladder fluke formula first before
attempting to detox for other parasites.

Start with something like
Paratosin– When detoxifying flukes for the first time, according to the
manufacturer, the usual dose of Paratosin for a 150-200lb adult is 12-18
capsules per day for 30 days. Repeat treatments, use 2-4 caps 3x day for 30
days.

Take something to move bowel and to cleanse the walls of the intestines
simultaneously, such as Premier Cleanse. This is a gentle but effective formula.

To go on and treat intestinal parasites try a product with herbs such as found in Parastat.

c. Endoscopy

Endoscopic
spincterotomy is a less invasive option compared to surgery. Through ERCP,
parasites can be extracted and nasobiliary drainage can be done as well. Antihelminthics
or drugs that expelparasitic worms are coursed through a tube inserted to the
nose and to the GI tract until it reaches the target area.

d. Surgery

Last
resort for acute and chronic cholecystitis due to parasites or stones. Surgery
can be used to extract the parasites.

How
can these parasites be avoided?

a. Wash your hands with soap and water several times a day.

b. Proper
cooking and food handling - Most
flukes, roundworms and other parasites affecting the intestines, liver and
gallbladder come from contaminated food. It is therefore important that you
observe proper food handling and cook your meats and vegetables sufficiently to
kill off any parasites that may be in them.

c. Change
dietary habits. If you
must eat out, avoid rare meats and raw food as much as possible. If you can’t,
try to find reputable places known for proper food handling and its quality
sanitation.

d. Make sure
you have clean water. Water
filters are very important. Be wary of the manner of your water storage as
well. If possible, bring your own water wherever you go. If you need to drink
water from elsewhere, make sure that you only take purified water from sealed
containers.

Causes of Gallbladder Disease

My Account

* These statements have not been evaluated by the Food and Drug Administration. The products and information on this website are not intended to diagnose, treat, cure or prevent any disease. The information on this site is for educational purposes only and should not be considered medical advice. Please speak with an appropriate healthcare professional when evaluating any wellness related therapy.